Transcutaneous vagus nerve stimulation (tVNS) enhances conflict-triggered adjustment of cognitive control.

Response conflicts play a prominent role in the flexible adaptation of behavior as they represent context-signals that indicate the necessity for the recruitment of cognitive control. Previous studies have highlighted the functional roles of the affectively aversive and arousing quality of the conflict signal in triggering the adaptation process. To further test this potential link with arousal, participants performed a response conflict task in two separate sessions with either transcutaneous vagus nerve stimulation (tVNS), which is assumed to activate the locus coeruleus-noradrenaline (LC-NE) system, or with neutral sham stimulation. In both sessions the N2 and P3 event-related potentials (ERP) were assessed. In line with previous findings, conflict interference, the N2 and P3 amplitude were reduced after conflict. Most importantly, this adaptation to conflict was enhanced under tVNS compared to sham stimulation for conflict interference and the N2 amplitude. No effect of tVNS on the P3 component was found. These findings suggest that tVNS increases behavioral and electrophysiological markers of adaptation to conflict. Results are discussed in the context of the potentially underlying LC-NE and other neuromodulatory (e.g., GABA) systems. The present findings add important pieces to the understanding of the neurophysiological mechanisms of conflict-triggered adjustment of cognitive control.

Attentional bias modification in reducing test anxiety vulnerability: a randomized controlled trial.

BACKGROUND: A tendency to selectively process a threat to positive information may be involved in the etiology of anxiety disorders. The aim of this study is to examine whether attentional bias modification (ABM) can be used to modify high test-anxiety individuals' attention to emotional information and whether this change is related to anxiety vulnerability. METHODS: Seventy-seven undergraduates were included: 28 individuals received a 5-day modified dot probe task as ABM training, 29 individuals received a 5-day classic dot probe task as placebo, and 20 individuals did not receive an intervention between the two test sections. In addition to the measure of biased attention, salivary α-amylase (sAA) and the visual analogue scale of anxiety were assessed as emotional reactivity to stress. RESULTS: A repeated measurement of variance analysis and paired sample t-test indicated that the ABM group showed a significant change in attentional bias scores after the 5-day training, whereas there were no changes in the attentional bias scores in the placebo or waiting list groups. Importantly, anxiety vulnerability with attention to threats was significantly decreased in the training group. CONCLUSIONS: These results suggest that attentional bias toward threat stimuli may play an important role in anxiety vulnerability. The attentional bias modification away from the threat is effective for the individuals preparing for an exam. TRIAL REGISTRATION: This trial was retrospectively registered on June 22, 2017 with the registration number ChiCTR-IOR-17011745 and the title 'Attentional Bias in high anxiety individuals and its modification'.

Measuring Resilience to Operational Stress in Canadian Armed Forces Personnel.

Adaptability to stress is governed by innate resilience, comprised of complex neuroendocrine and immune mechanisms alongside inherited or learned behavioral traits. Based on their capacity to adapt, some people thrive in stressful situations, whereas others experience maladaptation. In our study, we used state-of-the-art tools to assess the resilience level in individuals, as well as their susceptibility to developing military stress-induced behavioral and cognitive deficits. To address this complex question, we tested Canadian Armed Forces (CAF) personnel in three distinct stress environments (baselines): during predeployment training, deployment in Afghanistan, and readjustment upon return to Canada. Our comprehensive outcome measures included psychometric tests, saliva biomarkers, and computerized cognitive tests that used the Cambridge Neuropsychological Automated Test Battery. Participants were categorized based on initial biomarker measurements as being at low-, moderate-, or high stress-maladaptation risk. Biomarkers showed significant changes (ds = 0.56 to 2.44) between baselines, calculated as "delta" changes. Participants at low stress-maladaptation risk demonstrated minimal changes, whereas those at high stress-maladaptation risk showed significant biomarker variations. The psychometric patterns and cognitive functions were likewise affected across baselines, suggesting that the panel of saliva stress biomarkers could be a useful tool for determining the risk of stress maladaptation that can cause psychological and cognitive decline.

Social evaluative threat with verbal performance feedback alters neuroendocrine response to stress.

Laboratory stress tasks such as the Trier Social Stress Test (TSST) have provided a key piece to the puzzle for how psychosocial stress impacts the hypothalamic-pituitary-adrenal axis, other stress-responsive biomarkers, and ultimately wellbeing. These tasks are thought to work through biopsychosocial processes, specifically social evaluative threat and the uncontrollability heighten situational demands. The present study integrated an experimental modification to the design of the TSST to probe whether additional social evaluative threat, via negative verbal feedback about speech performance, can further alter stress reactivity in 63 men and women. This TSST study confirmed previous findings related to stress reactivity and stress recovery but extended this literature in several ways. First, we showed that additional social evaluative threat components, mid-task following the speech portion of the TSST, were still capable of enhancing the psychosocial stressor. Second, we considered stress-reactive hormones beyond cortisol to include dehydroepiandrosterone (DHEA) and testosterone, and found these hormones were also stress-responsive, and their release was coupled with one another. Third, we explored whether gain- and loss-framing incentive instructions, meant to influence performance motivation by enhancing the personal relevance of task performance, impacted hormonal reactivity. Results showed that each hormone was stress reactive and further had different responses to the modified TSST compared to the original TSST. Beyond the utility of showing how the TSST can be modified with heightened social evaluative threat and incentive-framing instructions, this study informs about how these three stress-responsive hormones have differential responses to the demands of a challenge and a stressor.

If the coping fits, use it: Preadolescent recent stress exposure differentially predicts post-TSST salivary cortisol recovery.

This study examined recent stress exposure and effortful coping effects on salivary cortisol (sC) response patterns in preadolescent boys and girls (N = 121, Mage = 10.60 years). Children were exposed to the Trier Social Stress Test (TSST) and one of two randomly assigned, post-TSST coping conditions: distraction and avoidance. Piecewise growth multilevel modeling did not link children's recent stressful life events or hair cortisol (hC) levels to sC reactivity, though each interacted with coping condition to predict sC recovery patterns. Children with elevated life stressor and hC levels demonstrated protracted sC recovery when primed with distraction, yet more efficient sC recovery when primed with avoidance. Findings challenge assumptions about universally "good" and "bad" coping by highlighting contexts where each succeed and fail in helping children manage acute stress physiology.

Laterality and body ownership: Effect of handedness on experience of the rubber hand illusion.

Body ownership has mainly been linked to the right hemisphere and larger interhemispheric connectivity has been shown to be associated with greater right hemispheric activation. Mixed-handed participants tend to have more interhemispheric connectivity compared to extreme handed participants. The aim of this study was to examine whether feelings of ownership as assessed with the rubber hand illusion (RHI) are differentiated by handedness and differed between the left and right hand. Sinistrals-, dextrals-, and mixed-handed individuals (n = 63) were subjected to the RHI. Stroking was synchronously and asynchronously performed on both the participant's hand and a rubber hand. Outcome measures were an embodiment questionnaire and proprioceptive drift. In contrast to our hypotheses we show a similar experience of ownership for all groups, which may indicate no hemispheric specialization for the illusion. In addition, plasticity of ownership and body ownership are similar for the left hand and right hand in all participants, which suggests similar representations for both hands in the brain. This might be useful to maintain a coherent sense of the body in space.

Maternal negative affect during infancy is linked to disrupted patterns of diurnal cortisol and alpha asymmetry across contexts during childhood.

Maternal negative affect in the early environment is believed to sensitize long-term coping capacities in children. Yet, little work has identified physiological systems associated with coping responses, which may serve as mechanisms for links between early maternal negativity and child outcomes. Using a longitudinal twin sample (N=89), we found that high levels of maternal negative affect during infancy were associated with dysregulation of diurnal cortisol and electroencephalograph (EEG) asymmetry, two physiological systems that may support active approach-oriented coping when children are 7years old. Flattened slopes of diurnal cortisol were also associated with greater numbers of concurrent overanxious behaviors in children. A mediation analysis supported the role of dysregulated diurnal cortisol as a mediator of the link between maternal negative affect in the early environment and childhood risk for anxiety problems.

Cortisol, Health, and Coping in Patients with Nonspecific Low Back Pain.

Subjective health complaints (SHC), including nonspecific low back pain (LBP) as the most common single complaint, are the main reasons for long-term sick leave in many western countries. These complaints are often attributed to "stress". Cortisol has frequently been considered a biomarker reflecting sustained physiological HPA-axis activity, and is characterized by a high cortisol awakening response (CAR) and low evening values. The aim of the study was to investigate whether LBP patients had a normal characteristic cortisol profile, and whether possible deviations were related to coping and health. 305 patients on long-term sick leave for LBP participated in the study, and saliva cortisol profiles were compared to a reference population consisting of Danish workers. Cortisol was measured upon awakening, after 30 min, and in the evening. Additionally, patients answered questionnaires about SHC, fatigue, pain, coping, and social support. The patients showed a seemingly normal cortisol profile. However, CAR was larger among patients compared to the reference population. Patients with low cortisol reactivity had more SHC, pain, and fatigue, and those with higher evening cortisol reported higher scores on coping. The results are discussed in terms of theory, practical considerations, and possible mechanisms for the association between cortisol, health, and coping.

The relation between gaze aversion and cortisol reactivity in middle childhood.

The present study sought to investigate the relation between ethological observations of children's gaze aversion during a psychosocial stress task and their cortisol reactivity to the task, and how this relation might be moderated by how stressful the children perceived the stress task to be. Videos of 140 children (74 girls; Mage=10.60years) performing a psychosocial stress task in front of a jury were coded for displays of the children's gaze aversion from the jury, and saliva samples were taken to determine their cortisol reactivity. A questionnaire assessed the children's level of perceived stress. Results showed higher cortisol reactivity in children who perceived the task as more stressful. Furthermore, a quadratic relation between gaze aversion and cortisol was found which depended on the level of perceived stress: for children with low levels of perceived stress, cortisol reactivity was lowest with intermediate levels of gaze aversion, whereas for children with high levels of perceived stress cortisol reactivity was highest at intermediate levels of gaze aversion. The results suggest a modest association between subjective and physiological stress responses in 9- to 11-year-olds, and indicate that gaze aversion may play only a minor role as a behavioural coping strategy at this age.

Associations between infants' crying, sleep and cortisol secretion and mother's sleep and well-being.

BACKGROUND: Infants' continuous crying is a challenge both for the child and the principal caregiver. However, the links between infants' sleep, crying and cortisol secretion and mothers' well-being and sleep have been scarcely investigated. The aim of the present study was therefore to examine the link between cortisol secretion, crying and sleep of infants characterized by infantile colic (IC) and mothers' psychological well-being and own sleep. METHODS: Mothers of 24 infants characterized by IC (mean age = 8 weeks, SD = 1.5 weeks) completed a series of questionnaires regarding the infant's crying and sleeping patterns. Infants' sleep was objectively assessed with actigraphs. Cortisol secretion was measured by means of saliva samples in the mornings after waking. After 4 weeks, infants were assessed once again. Mothers completed questionnaires assessing their psychological well-being (depressive symptoms, family strain) and sleep. RESULTS: Mothers' psychological well-being and sleep was greatly predicted by infants' morning saliva cortisol levels, sleep disruptions and crying intensity, whereas infants' crying duration and volume had low predictive value. CONCLUSIONS: Mothers with infants characterized by IC are at increased risk for reporting impaired sleep, developing depressive symptoms and reporting higher family strain. Most importantly, this risk seems to be greater if their infants' sleep is fragmented.

Dismissing child attachment and discordance for subjective and neuroendocrine responses to vulnerability.

Emerging evidence suggests that as with adults, dismissing children underreport their psychological distress relative to physiological indicators of their experience (startle response, neural signals). In this report, we extend these observations to neuroendocrine reactivity. One hundred and six 8-12-year-old children completed the Child Attachment Interview and a computer-based paradigm comprised of vignettes reflecting vulnerability in interpersonal contexts. Dismissing children's cortisol responses remained comparable from pre-to-post paradigm, while secure children's cortisol responses decreased from pre-to-post paradigm. Furthermore, compared to secure children, dismissing children reported less distress than their cortisol response would suggest. Implications for dismissing children's coping and self-regulation are discussed.

Perfectionism, emotion regulation, and the cortisol stress response.

To provide counseling psychologists with a greater understanding of patterns of personality, stress, and emotion regulation, the present study examined perfectionists' typical emotion regulation patterns and physiological reactivity (salivary cortisol concentration) to a social-evaluative stress experience. An initially large sample (N = 421) completed measures of perfectionism, higher order personality factors, and emotion regulation. A subset of the larger sample (N = 61) completed the Trier Social Stress Test. Latent profile analysis revealed typologies consistent with more and less adaptively perfectionistic groups, as reflected in different stress reactivity and emotion regulation patterns. The results have implications for further understanding the positive and negative effects of perfectionism and physiological reactivity to performance stress among individuals with high performance expectations. In addition, the results may inform counseling psychologists about viable targets for therapeutic interventions for stress and emotion regulation.

Coping and empowerment preventive intervention buffers early adolescent neuroendocrine-related risk for internalizing problems.

There is an absence of mechanism-driven interventions equipped to reduce the large mental health disparities that exist for preadolescent youth living in poverty. Building a Strong Identity and Coping Skills (BaSICS) is a preventive intervention designed to target multiple aspects of poverty-related stress adaptation, including altered neuroendocrine function. The purpose of the current study was to examine whether pre-post shifts in preadolescent hypothalamic-pituitary-adrenal (HPA) activation could longitudinally predict internalizing outcomes and to determine whether BaSICS could buffer such HPA-related risk for psychopathology. Low-income youth (n = 112) ages 11-12 years were randomized to the 16-session intervention or assessment-only control (53% intervention; 54% female; 40% Hispanic, 63% Black, 20% White). Youth completed questionnaires and the Trier Social Stress Test, and provided cortisol via saliva at six timepoints during the 90-minute assessment. Adjusting for pre-intervention Cortisol Area Under the Curve-Ground (CAUCg) scores and internalizing problems, post-intervention CAUCg and intervention main and interactive effects were modeled as predictors of internalizing outcomes across post-intervention, 6-month, and 12-month follow-up assessments using multilevel regression methods. A significant post-intervention CAUCg by intervention interaction emerged (B=1.198, SE=0.433, p = .006). For control youth, baseline-adjusted decreases in cortisol output were associated with increases in internalizing problems that remained stably elevated across follow-up assessments. For BaSICS youth, however, internalizing problems decreased and remained stably low following program delivery, irrespective of post-intervention increases or decreases in cortisol output. Findings illustrate how BaSICS may buffer against HPA-related risk for internalizing psychopathology and provide support for interventions targeting biological mechanisms of risk for low-income preadolescents.

Too much of a good thing?: Positive religious coping predicts worse diurnal salivary cortisol patterns for overwhelmed African American female dementia family caregivers.

OBJECTIVES: Religious coping arguably prevents negative health outcomes for stressed persons. This study examined the moderating role of religious coping (positive, negative, and combined) in the connection of care recipient functional status with diurnal salivary cortisol patterns among dementia family caregivers. METHODS: Thirty African American (AA) female dementia caregivers and 48 AA noncaregivers completed the Religious Coping (RCOPE) scale, the Activities of Daily Living scale, and the Revised Memory and Behavior Problem Checklist (RMBPC) and collected five saliva samples daily (at awakening, 9 A.M., 12 P.M., 5 P.M., and 9 P.M.) for 2 straight days. RESULTS: Hierarchical regression tests with mean diurnal cortisol slope as the outcome illustrated surprisingly that higher combined and positive (but not negative) RCOPE scores were associated with increasingly flatter or worse cortisol slope scores for caregivers (but not noncaregivers). Of note, the RCOPE by RMBPC interaction was significant. Among caregivers who reported higher RMBPC scores, higher combined and positive (but not negative) RCOPE scores were unexpectedly associated with increasingly flatter cortisol slopes. CONCLUSIONS: These results extend current findings by showing that being AA, a caregiver, and high in positive religious coping may predict increased daily stress responses, mainly for those with higher patient behavioral problems. Because religious coping is a central coping strategy for AA caregivers, it is vital that epidemiologic assessments of religious coping in health and aging as well as tailored interventions focus on the unique reasons for this disparity.

Effects of parental depressive symptoms on child adjustment moderated by hypothalamic pituitary adrenal activity: within- and between-family risk.

Child hypothalamic pituitary adrenal (HPA) activity was investigated as a moderator of parental depressive symptom effects on child behavior in an adoption sample (n = 210 families). Adoptive parents' depressive symptoms and child internalizing and externalizing were assessed at 18, 27, and 54 months, and child morning and evening HPA activity measured through salivary cortisol at 54 months. Children's daily cortisol levels and day-to-day variability were tested as moderators of longitudinal associations between parent and child symptoms at within- and between-family levels. Mothers' symptoms related directly to child internalizing, but child evening cortisol moderated effects of fathers' symptoms on internalizing, and of both parents' symptoms on externalizing. Different paths of within-family risk dynamics versus between-family risk synergy were found for internalizing versus externalizing outcomes.

Psychological and environmental correlates of HPA axis functioning in parentally bereaved children: preliminary findings.

This study examined bereaved children's HPA-axis functioning (cortisol awakening response; CAR) in relation to psychological distress, coping, and surviving parents' grief reactions. Participants included 38 children (20 girls) with recent parental loss (previous 6 months) and 28 of their surviving caregivers (23 women) who were assessed using self-report instruments and in-person, semistructured interviews. Interviews involved discussions about the child's thoughts and feelings related to the loss. Participants provided 3 saliva samples at home (awakening, 30 minutes later, and evening) over 3 successive days, beginning on the day following the interview. Results show a significant relation between dampening of the child's Day 1 CAR and more symptoms of anxiety (r = -.45), depression (r = -.40), posttraumatic stress (r = -.45), and maladaptive grief (r = -.43), as well as higher levels of avoidant coping (r = -.53). Higher levels of parental maladaptive grief were also associated (r = -.47) with a dampening of the child's Day 1 CAR. Our results raise the possibility that blunted CAR may be a result of accumulating allostatic load and/or a result of emotionally challenging events (discussions regarding the deceased) and their subsequent processing (or lack thereof) within the family, which may be particularly stressful for those bereaved children experiencing high levels of psychological distress, avoidant coping, and parental maladaptive grief.

The physiological expression of living in disadvantaged neighborhoods for youth.

Evidence suggests that the consequences of chronic exposure to stressors extend beyond psychological effects, and that adolescents living in socio-economically disadvantaged neighborhoods may experience an accumulation of exposure to stressors that wears down the physical systems in the body, resulting in hyper-activation of the stress response. This research examines the relationship between exposure to neighborhood stressors and salivary cortisol reactivity in a sample of 163 at-risk African American adolescents (average age 21; 50% female) living in disadvantaged urban neighborhoods. More specifically, the relationship between neighborhood stressors and physiological stress, measured by baseline cortisol and cortisol reactivity is assessed. This research also examines several moderating pathways between exposure to neighborhood disadvantage and cortisol reactivity including substance use, high effort coping, psychological stress and social support. Results indicate that both individual and neighborhood-level factors influence adolescent cortisol. High effort coping and psychological stress were associated with cortisol in the sample, and exposure to neighborhood socio-economic disadvantage resulted in an atypical cortisol response. In addition, neighborhood disadvantage interacted with intra- and interpersonal factors to affect cortisol indirectly. Thus, living in disadvantaged neighborhoods may take a psychological and physiological toll on adolescents, and it also may exert synergistic effects through individual coping and vulnerabilities.

[Psychological effects of orthognatic surgery and postoperative dissatisfaction: presentation of a research protocol]. / Effets psychologiques de la chirurgie orthognatique et insatisfaction postopératoire : présentation d'un protocole de recherche.

INTRODUCTION: The causes of postoperative dissatisfaction in orthognathic surgery are difficult to grasp. The aims of our study are to analyze the effects of orthognathic surgery on self-esteem, body image, psychological morbidity, and quality of life. We also want to assess the combined effects of these factors on postoperative dissatisfaction, and to study the interest of personality assessment (especially neuroticism) as a predictive factor of dissatisfaction. METHOD: Three hundred patients candidates for maxillo-mandibular osteotomy will be included in the study. They will answer a questionnaire assessing self-esteem, body image, psychological morbidity, quality of life, and personality. The evaluation will be conducted preoperatively and postoperatively at 3 months and at 1 year. The degree of satisfaction will be measured postoperatively. EXPECTED RESULTS: The results should help evaluate the psychological effects of orthognathic surgery and identify predictors of postoperative dissatisfaction, and especially the role of neuroticism.

Planful versus avoidant coping: behavior of individuals with moderate-to-severe traumatic brain injury during a psychosocial stress test.

Many people who sustain traumatic brain injuries (TBI) have poor psychosocial outcomes that have been related to the use of avoidant coping. A major obstacle to understanding the mechanisms of this relationship are the self-report measures by which coping has been traditionally evaluated. The purpose of the present study was to compare coping behavior during a simulated real-world stress test with self-reported coping. People with moderate-to-severe TBI and matched controls completed the Baycrest Psychosocial Stress Test (BPST) where coping behavior was evaluated, and also completed the Ways of Coping Questionnaire (WOC). While there were no group differences in self- or significant-other-reported behavior on the WOC, the TBI group engaged in more avoidant than planful behavior on the BPST, while the control group displayed the opposite pattern of behavior. Moreover, in the control group there were positive relations between behavior on the BPST and self-reported coping on the WOC, but no such relation within the TBI group. Secondary analyses allowed for TBI participants to be characterized as "planners" or "avoiders." This is the first study, to our knowledge, to report behavioral differences in coping post-TBI. Future work investigating the moderators of these differences may have significant implications for rehabilitative intervention.

Persistent orofacial muscle pain.

The pathophysiology of persistent orofacial myalgia has been the centre of much controversy. In this article we suggest a novel descriptive term; 'persistent orofacial muscle pain' (POMP) and review current evidence that supports the hypothesis that the induction of POMP involves the interplay between a peripheral nociceptive source in muscle, a faulty central nervous system component and decreased coping ability. In this context it is widely accepted that a complex interaction of variable intrinsic and extrinsic factors act to induce POMP and dysfunction.